What marks progression to proliferative diabetic retinopathy?

What marks progression to proliferative diabetic retinopathy?

• A. Retinal detachment due to lattice degeneration
• B. Cotton-wool spots in nerve fiber layer
• C. Neovascularization on retina or optic disc, with risk of vitreous hemorrhage
• D. Macular edema with thickening

Answer: (C)

Progression to proliferative diabetic retinopathy is defined by the growth of new, abnormal blood vessels on the retina or optic disc. This neovascularization arises from retinal ischemia and is driven by factors like VEGF. These fragile vessels are prone to rupture, leading to vitreous hemorrhage, and the accompanying fibrovascular tissue can pull on the retina, causing tractional retinal detachment. Cotton-wool spots are microinfarcts seen in nonproliferative stages, and macular edema with thickening can occur with or without neovascularization. They indicate diabetic retinopathy but not the proliferative stage. Retinal detachment from lattice degeneration is a separate peripheral retinal condition not specific to proliferative diabetic changes.

Progression to proliferative diabetic retinopathy is defined by the growth of new, abnormal blood vessels on the retina or optic disc. This neovascularization arises from retinal ischemia and is driven by factors like VEGF. These fragile vessels are prone to rupture, leading to vitreous hemorrhage, and the accompanying fibrovascular tissue can pull on the retina, causing tractional retinal detachment.

Cotton-wool spots are microinfarcts seen in nonproliferative stages, and macular edema with thickening can occur with or without neovascularization. They indicate diabetic retinopathy but not the proliferative stage. Retinal detachment from lattice degeneration is a separate peripheral retinal condition not specific to proliferative diabetic changes.